Garvan Walshe is a former National and International Security Policy Adviser to the Conservative Party.
Having detected three cases of Covid–19, Melbourne has been put into lockdown. The European Centre for Disease Control suggests it might have to be maintained until the summer. Germany is getting increasingly jumpy about new variants, despite never exceeding 300 cases per 100,000 people.
Spurred by vaccine delays – particularly acute thanks to the European Commision’s utter mess of procurment – a narrative is taking hold. It states that the vaccines are ineffective against new variants, and could be ineffective against variants yet to emerge. What is needed, the argument goes, is to prevent the circulation of the virus, and therefore the chance that these variants could ever emerge.
We know, of course that for the elderly, and for those with co-morbidities, Covid is lethal. In old and fat Western societies, these can easily be millions of people. For the rest of us, it, with a few exceptions, is not unlike other afflictions: it ranges from utterly harmless to deeply unpleasant – sometimes with long-term effects. We don’t shut society down to eliminate these in the case of other diseases.
For the last year, most of these populations have been deprived of their freedom. They have sacrificed their ability to pursue their normal life and exist as social beings in order to protect the vulnerable in society. Perhaps the introverted don’t mind do much: the other day I asked a friend, a writer of scholarly books who lives in America, how he was coping, and he replied “since I’m a hermit, I’ve nothing to complain about”.
But some of us like company, and have been hard hit. And since in our open societies people tend to gravitate to jobs that suit them, the inequality is sharpened.
Strict, long confinements like France’s and Belgium’s are the toughest to bear. In Spain, by contrast, cafes and restaurants have usually remained open, if for fewer hours. People with secure jobs in the public sector will come out of this pandemic with higher savings ,because there’s nothing to spend money on.
But if you run a small business, the difficulty in meeting people makes finding new clients extremely hard, even if you’re not in a sector hit by restrictions. It’s worst of all for workers in hospitality and travel – hugely improtant in sunny southern Europe.
The mental health effects of enforced solitude are only slightly leavened by our knowledge that everybody else is going through the same thing. Thankfully, Spanish and Italian authorities have been less draconian this time, and don’t restrict people from walking outside.
That’s not the case in Paris, where you are formally limited to staying within a kilometre of your home. It goes without saying that it helps to be richer: self-isolating in a cramped flatshare with unsympathetic housemates is much more difficult than in a spacious family home with a garden. For people trapped in abusive relationships, it’s a living hell.
It’s one thing to endure all this in order to prevent people dying, and for a relatively short period of time; quite another because something could happen that might return us to this situation. Our nerves are already wearing thin, capital running low and reserves of hope becoming exhausted.
As the most basic level, the aggregate effect of vaccination is to reduce the number of people susceptible to the virus. So what would happen if restrictions were lifted entirely once the vulnerable were vaccinated?
If 80 per cent of the vulnerable are vaccinated, instead of 10–15 per cent of the population being at serious risk, then two to three per cent are. If their infection fatality rate is five per cent, they are all infected, and vaccination is 70 per cent effective, that would result in 0.2 per cent death rate – or around 90,000–120,000 deaths in the UK.
But in reality, their death and serious illness numbers would be considerably lower than that. For a start, they would not all be infected. Though vaccination is at least 70 per cent effective against infection, it is 100 per cent effective against serious illness and death: this is true even for the variants. We can be sure that anyone who has been vaccinated won’t die of Covid.
Indeed, evidence is now emerging that vaccination reduces transmissibility as well as severity of infection: this is good in itself, and also because it reduces the number of copies of the virus that are capable of generating mutations, and therefore the likelihood of more troublesome variants emerging.
Finally, with good surveillance of infection strains, we will have time to adapt the vaccine to variants that emerge. This is because the maths of exponential growth leads to an explosion, but only after a phase of slow expansion. That phase, which lasts several months with Covid, is enough time to refine vaccines, provided the mutations are detected early.
This changes the calculation that justified the earlier lockdowns. Last year, Imperial College’s modelling calculated that 550,000 people could die, and so justified the extreme restrictions that were imposed.
As the threat recedes, reopening should not be an all or nothing affair. Measures that don’t cost very much, such as tests before international travel, masks on public transport, working from home where possible, limitations on capacity for cinemas and theatres, bans on large events where superspreading can occur, and so on, should continue for longer.
But basic restrictions on seeing our fellow human beings, particularly outside, and on people who make their living serving food and drink while we do so need to be among the first to go.
Timing is critical, of course, because vaccinations take a few weeks before they generate strong immunity, but their effects can be tested by observing the number of more severe cases and hospitalisations. The dramatic success of Israel’s vaccination programme has been overshadowed by the ultra-Orthodox community’s refusal to take part in even basic social distancing but, even there, the make-up of hospitalisations has changed. As vaccines are distributed, the proportion of severe cases will go down, and pressure on hospitals will ease, allowing more opening up. This – not the mere fact of vaccines being administered, nor the complete elimination of Covid cases – is the essential metric.
Actual eradication of viruses is extremely difficult, and seems only to have been achieved with smallpox. Covid will stay endemic and mutate in the world population. However, that’s not as scary as it sounds. The virus only cares about replicating and finding new hosts. Mutations that help it spread harmlessly are much more useful to Covid than the ones that kill us.
As long as most of us are exposed to it while young, like the other coronaviruses that circulate and cause colds, it won’t cause a public health crisis. That, not zero-covid, is an outcome that we, and the virus can both live with.